一種麻藥使一個女人的血變藍(lán)了

一種麻藥使一個女人的血變藍(lán)了

A 25-year-old woman walked into an emergency department in Providence, Rhode Island, complaining of generalized weakness, fatigue, shortness of breath... and an unusual symptom you don't see every day.

一名25歲的女子走進(jìn)羅德島州普羅維登斯市的急診室，抱怨全身虛弱、乏力、呼吸急促……這種不尋常的癥狀不是每天都能看到的。

She was turning blue.

她身體發(fā)青。

Drs. Otis Warren and Benjamin Blackwood wrote about the case in a study published in the New England Journal of Medicine on Thursday.

奧蒂斯·沃倫博士和本杰明·布萊克伍德博士于周四發(fā)表在《新英格蘭醫(yī)學(xué)雜志》上的一項(xiàng)研究中寫道這一病例。

They attributed her blueness to a numbing agent the woman was using, which deadens nerve endings in the skin.

他們將她全身發(fā)藍(lán)歸因于她使用的一種麻醉劑，這種麻醉劑會使皮膚中的神經(jīng)末梢麻木。

"She reported having used large amounts of topical benzocaine the night before for a toothache," the two co-authors wrote.

“她報(bào)告說，前一天晚上她用了大量局部苯佐卡因治療牙痛，”兩位合著者寫道。

Warren, an emergency medicine physician at Miriam Hospital in Providence, told CNN he'd only ever seen one other "blue" patient while completing his residency. It stuck with him, so he was immediately able to identify the woman's condition.

沃倫是普羅維登斯市米里亞姆醫(yī)院的急診醫(yī)生，他告訴CNN，他在完成住院醫(yī)生實(shí)習(xí)期間只見過一位“藍(lán)色”病人。這讓他難以釋懷，所以他很快就能確定這名女子的病情。

"It's one of those rare cases that we're taught about, you study for, you take tests on, but you rarely ever see," he told CNN.

他在接受CNN采訪時表示:“這是我們所學(xué)到的罕見案例之一，你要為之學(xué)習(xí)，要參加考試，但你很少看到。”

Her condition kept blood from tissue

她的病情使血液無法進(jìn)入組織

Warren diagnosed her with "acquired methemoglobinemia," a reaction caused by certain medicines that stops blood from carrying oxygen to tissue, he said.

沃倫診斷她患有“獲得性高鐵血紅蛋白血癥”，他說，這是一種由某些藥物引起的反應(yīng)，可以阻止血液向組織輸送氧氣。

Blood binds with oxygen and doesn't release it to the tissue where it's needed. And thus, the patient appears blue.

血液與氧氣結(jié)合，不把氧氣釋放到需要氧氣的組織中。因此，病人血液呈現(xiàn)藍(lán)色。

The antidote is a brilliant blue, too. Methylene blue returns a missing electron to the hemoglobin molecule that restores oxygen levels and helps release oxygen back into tissue, he said.

解藥也是一種亮藍(lán)色。亞甲基藍(lán)將缺失的電子返回到血紅蛋白分子中，血紅蛋白分子可以恢復(fù)氧氣水平，并幫助將氧氣釋放回組織中，他說。

"In my field, emergency medicine, when you can cure a patient with a single antidote--that's a rare thing for us," he said.

他說:“在我的急診醫(yī)學(xué)領(lǐng)域，你可以用只一種解藥治愈病人，這對我們來說是很罕見的。”

In his patient's case, her reaction was caused by benzocaine, an active ingredient found in cold sore medicine. And while hers is a rare side effect, it warranted a warning from the Food and Drug Administration, which cautioned against its use in children under 2, who sometimes take the medicine to soothe teething pain.

在他的病人身上，她的反應(yīng)是由苯佐卡因引起的，苯佐卡因是一種存在于感冒藥中的活性成分。雖然她的副作用很少見，但美國食品和藥物管理局對此提出了警告，該機(jī)構(gòu)告誡2歲以下兒童不要使用這種藥物，因?yàn)樗麄冇袝r會服用這種藥物來緩解牙齒疼痛。

Warren's patient recovered after two doses of methylene blue and an overnight stay at the hospital. But when levels of the mutated blood rise 50% or higher, patients can enter a coma or develop heart and brain complications from the lack of blood to tissue. Any amount over 60% can cause death, he said.

沃倫的病人服用了兩劑亞甲藍(lán)，并在醫(yī)院住了一晚，后來才康復(fù)。但是，當(dāng)變異血液的水平上升到50%或更高時，患者可能會進(jìn)入昏迷狀態(tài)，或因組織中缺乏血液而出現(xiàn)心臟和大腦并發(fā)癥。他說，當(dāng)變異血液的水平上升到60%以上的任何水平時都可能導(dǎo)致死亡。